The task
Assume that today's date is 5 November 2026. Mr Adebiyi Babtunde is being discharged home this afternoon. This is an original independent practice task. Allow 45 minutes: 5 minutes for reading and 40 minutes for writing.
You are a registered nurse on a stroke unit. Using the case notes, write a discharge letter to Ms Wuraola Ogunbo, Stroke Early-Supported-Discharge Nurse, Home Rehabilitation Service, 24 Park Road, SW1V 2RF, United Kingdom. Request continued home rehabilitation, explaining Mr Babtunde's communication and assistance needs and the documented assessment of his capacity regarding discharge. In your answer: expand the relevant notes into complete sentences; do not use note form; use letter format. The body of the letter should be approximately 180–200 words.
Length: the body of the letter should be about 180–200 words. You have 45 minutes in the test: 5 minutes to read, 40 to write. Letter type: Discharge letter.
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Which case notes belong in this letter?
Stroke with expressive aphasia: discharge
You are a registered nurse on a stroke unit. Using the case notes, write a discharge letter to Ms Wuraola Ogunbo, Stroke Early-Supported-Discharge Nurse, Home Rehabilitation Service, 24 Park Road, SW1V 2RF, United Kingdom. Request continued home rehabilitation, explaining Mr Babtunde's communication and assistance needs and the documented assessment of his capacity regarding discharge. In your answer: expand the relevant notes into complete sentences; do not use note form; use letter format. The body of the letter should be approximately 180–200 words.
Mark every line: Include keeps the specific detail; Compress keeps the relevant gist in fewer words; Omit leaves it out. Then compare your choices with our reviewed analysis. Some choices are optional.
Download practice checklist (PDF)
One-page worksheet. Answers and reasons are on the linked webpage, so you can practise before checking.
Case notes
Patient details
- Name: Mr Adebiyi Babtunde
- DOB: 12/03/1958 (68 yrs)
- Home: 18 Park Road, SW1V 2RF, United Kingdom
- Admitted 24/10/26; discharge home 05/11/26
Social background
- Lives with wife; available throughout initial recovery
- Previously independent; retired accountant
- Enjoys gardening and radio quizzes
- Daughter's private financial dispute discussed with staff
Medical history
- Hypertension; hypercholesterolaemia
- Appendicectomy 1980; no ongoing problems
Assessment and communication
- 24/10: left hemispheric ischaemic stroke
- Initially R arm weakness + marked word-finding difficulty
- 05/11: expressive aphasia persists; short phrases, gestures
- SLT: understands short spoken sentences; lengthy explanations difficult
- SLT plan: quiet setting; one short question; allow response time; do not finish sentences
- SLT plan: picture board/gestures; confirm intended meaning; board supplied
- Reading: single familiar words; paragraphs difficult
- 04/11 supported assessment: understood, retained/weighed home-discharge options; communicated choice by pointing; capacity for this decision documented
- Patient requests direct involvement; wife may support, not answer automatically
- Frustrated when rushed; settles with time
Treatment and progress
- Independent bed/chair transfers, toileting and indoor walking; no aid
- Home assessment: level access; shower chair installed
- OT plan: wife assists showering, upper-body dressing and hot-meal preparation; R hand remains weak
- Wife demonstrated agreed assistance safely
- Regular diet, normal fluids; independently feeds himself
- Fatigue ↑ after lengthy conversations; prefers morning visits
Discharge plan
- Home rehabilitation accepted; patient agrees
- SLT home visit booked 06/11; continue communication practice
- Nursing visit agreed 06/11: review assistance arrangements, reinforce communication strategies, coordinate rehabilitation goals with patient
- Patient's goal: express daily needs independently
- Complained that ward television programmes were boring
- Team safety advice: sudden new/worsening face weakness, arm weakness or speech difficulty → call 999 immediately, even if transient
Who is reading, and what do they need?
Ms Wuraola Ogunbo is the early-supported-discharge nurse receiving this handover for accepted home rehabilitation, which the patient agrees to. She needs the destination, practical communication and assistance instructions, discharge-capacity findings and actions for her visit. He requests direct involvement, with his wife supporting rather than automatically answering. Prioritise actionable detail over routine history so she can continue rehabilitation with him.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Home: 18 Park Road, SW1V 2RF, United Kingdom. | Identifies the destination for home visits and distinguishes the patient's address from the recipient's nearby service address. |
| Quiet setting; one short question; allow response time; do not finish sentences. | Gives the receiving nurse the complete practical approach needed to support his participation during assessment and rehabilitation. |
| Supplied picture board/gestures; confirm intended meaning. | Identifies available communication support and the checking step needed when interpreting his responses. |
| 04/11: understood, retained/weighed home-discharge options; choice communicated by pointing; capacity documented for this decision. | Answers the explicit capacity-handover request while preserving the assessment's supported nature and decision-specific scope. |
| Right-hand weakness; wife assists showering, upper-body dressing and hot-meal preparation. | Specifies all three agreed assistance tasks for the nurse's review of home arrangements. |
| 06/11 nursing visit: review assistance, reinforce communication strategies, coordinate rehabilitation goals with patient. | Makes the receiving nurse's agreed timing and all three responsibilities explicit. |
| Sudden new/worsening face weakness, arm weakness or speech difficulty: immediately call 999, even if transient. | Preserves the documented emergency action, every listed symptom and the instruction to act even when symptoms resolve. |
| 05/11 home discharge after left hemispheric ischaemic stroke; persistent expressive aphasia. | Provides concise clinical context for the rehabilitation request and the detailed communication instructions. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Previously independent; retired accountant. | Previous independence is optional rehabilitation context; his former occupation does not guide home care. |
| Enjoys gardening and radio quizzes. | These interests are not linked to the agreed rehabilitation actions or his stated communication goal. |
| Daughter's private financial dispute discussed with staff. | This confidential third-party matter has no documented connection to his discharge support or rehabilitation. |
| Appendicectomy in 1980; no ongoing problems. | The resolved surgical history does not affect the receiving nurse's immediate rehabilitation responsibilities. |
| Ward television programmes described as boring. | The complaint does not identify an ongoing care need or an action for the home service. |
A paragraph plan for this case
Open with the home-rehabilitation request, Mr Babtunde's identifying details, including DOB 12/03/1958, and discharge home on 05/11 following admission on 24/10; establish the stroke and current aphasia, compressing the initial arm weakness and word-finding difficulty if used. Follow with supported communication, decision-specific capacity, direct patient involvement and assistance needs; optional context includes his wife's initial availability and demonstrated safe assistance, independent transfers/toileting/indoor walking without an aid, level access/shower chair, and independent feeding with regular diet and normal fluids. Close with the agreed 06/11 nursing review, the SLT visit booked that day, his goal of expressing daily needs independently and emergency advice; morning visits and fatigue after lengthy conversations can inform scheduling, while hypertension and hypercholesterolaemia need only brief background if space permits.
Where candidates slip on this task
- Do not equate expressive aphasia with incapacity: the 04/11 supported assessment documented capacity specifically for discharge, including understanding, retention, weighing options and communicating his choice by pointing.
- Keep communication accessible: short spoken sentences are understood, lengthy explanations and paragraphs are difficult, and reading is limited to familiar single words; frustration when rushed settles with time.
- Preserve the complete emergency instruction: sudden new or worsening face weakness, arm weakness or speech difficulty requires an immediate 999 call, even if transient; this case uses UK emergency arrangements.
No model letter is published here. Write for the named reader from the case notes in the timed editor, then get it marked.
Write it in the timed editor and get marked on the 6 criteria
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Your profession's guide: OET Nursing. Layout and structure: OET letter format.
Questions about this task
How much detail about the capacity assessment belongs in this handover?
Retain the assessment date, its supported nature and its specific focus on home discharge. Summarise understanding, retention and weighing of options, plus communication by pointing. Avoid extending this documented finding to every decision or treating expressive aphasia as evidence of incapacity.
Must every functional and background detail be included?
Prioritise the wife's three assistance tasks and the nurse's agreed review. Independent activities, home adaptations, the wife's demonstrated assistance and visit preferences can support that account when space allows. The SLT booking and patient goal help coordination, but each useful supporting detail need not appear.
Sources
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